[NCEH] Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey (ACBS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
ACBS Child Consent and Questionnaire	Form and Instruction	Modified	Available
ACBS Consent and Survey - Child	Form and Instruction	Modified	Repair queued
ACBS Adult Consent and Questionnaire	Form and Instruction	Modified	Available
ACBS Consent and Survey - Adult	Form and Instruction	Modified	Repair queued
Cell Phone Screener - Child	Form	Modified	Available
Cellphone Screener - Child	Form	Modified	Repair queued
Landline Screener - Child	Form	Modified	Available
Landline Screener - Child	Form	Modified	Repair queued
Cell Phone Screener - Adult	Form	Modified	Available
Cell Phone Screener - Adult	Form	Modified	Repair queued
Landline Screener - Adult	Form	Modified	Available
Landline Screener - Adult	Form	Modified	Repair queued
Att14 Design Oprtn NAS.pdf	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att13 ACBS Smmry Data Quality Rpr.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att12 ACBS Resp Rate Formulae.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att11 ACBS 2020 Response Rates.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att10 ACBS Dspstn Codes Call-back Rules.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att9 ACBS Dt Cllctn Prcss.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att8b BRFSS IRB statement.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att8a NCEH-ATSDR Research Determination Form.pdf	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att7a BRFSS 2021 Data Com.pdf	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att7 BRFSS Data Collection protocol 2023 Rev.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att6d BRFSS OMB SSB 2023 Rev.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att6c BRFSS OMB SSA 2023 Rev.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att6a BRFSS Privacy Cnfdlty Protctn 2023 Rev.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att6 2023 BRFSS Questionnaire 2023 Rev.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att4 ACBS Dt Cllctn Gdlns 2023 Rev.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att3 ListACBSAwrdeeStates 2023.docx	Supplementary Document	Uploaded 2023-07-05	Repair queued
Att2 ACBS 2023 60D Publication.pdf	Supplementary Document	Uploaded 2023-07-05	Available
Att1 ACBS Authorizing Legislation 2023 Rev.pdf	Supplementary Document	Uploaded 2023-07-05	Repair queued
1 - ACBS ListAttchmnts 2023 Rev.docx	Supplementary Document	Uploaded 2023-07-05	Available
1 - SSB ACBS OMB 2023 Rev.docx	Supporting Statement B	Uploaded 2023-07-05	Repair queued
1 - SSA ACBS OMB 2023 Rev_06272023.docx	Supporting Statement A	Uploaded 2023-07-05	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
243153	ACBS Data Submission Layout - Child	Other-Data Submission Layout - Child	Modified
224745	ACBS Data Submission Layout - Adult	Other-Data Submission Layout - Adult	Modified
224744	ACBS Consent and Survey - Child	Form and Instruction	Modified	ACBS Child Consent and Questionnaire
224744	ACBS Consent and Survey - Child	Form and Instruction	Modified
224743	ACBS Consent and Survey - Adult	Form and Instruction	Modified	ACBS Adult Consent and Questionnaire
224743	ACBS Consent and Survey - Adult	Form and Instruction	Modified
224742	Cellphone Screener - Child	Form	Modified	Cell Phone Screener - Child
224742	Cellphone Screener - Child	Form	Modified
224741	Landline Screener - Child	Form	Modified	Landline Screener - Child
224741	Landline Screener - Child	Form	Modified
224740	Cell Phone Screener - Adult	Form	Modified	Cell Phone Screener - Adult
224740	Cell Phone Screener - Adult	Form	Modified
224739	Landline Screener - Adult	Form	Modified	Landline Screener - Adult
224739	Landline Screener - Adult	Form	Modified

ICR Details

OMB Control No: 0920-1204	ICR Reference No: 202306-0920-014
Status: Historical Active	Previous ICR Reference No: 202008-0920-004
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1204
Title: [NCEH] Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey (ACBS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/11/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/07/2023
Terms of Clearance: Previous terms continue: ACBS staff should continue to collaborate with BRFSS staff to transparently present a) joint response rates from BRFSS and ACBS and b) potential non-response bias. Tables of prevalence estimates and risk factors disseminated by CDC (either through its web page or publications) should clearly communicate the caveats of state-to-state comparisons. ACBS should continue to assess options for streamlining the instrument to reduce unnecessary burden and synchronize question wording with recent studies.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2026	36 Months From Approved	11/30/2023
Responses	58,772	0	68,846
Time Burden (Hours)	6,073	0	6,615
Cost Burden (Dollars)	0	0	0

---

Abstract: The goal is to add depth to the existing body of asthma data and address questions surrounding the health and experiences of persons with asthma. Data are collected through a follow-up survey approximately two weeks after the BRFSS survey. Information is used by asthma control programs in state health departments and at the federal level.

---

Authorizing Statute(s): US Code: 42 USC 247 Name of Law: PHSA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 13825	03/06/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 43353	07/07/2023
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
ACBS Consent and Survey - Adult	None	ACBS Adult Consent and Questionnaire
ACBS Consent and Survey - Child	None	ACBS Child Consent and Questionnaire
ACBS Data Submission Layout - Adult
ACBS Data Submission Layout - Child
Cell Phone Screener - Adult	None	Cell Phone Screener - Adult
Cellphone Screener - Child	None	Cell Phone Screener - Child
Landline Screener - Adult	None	Landline Screener - Adult
Landline Screener - Child	None	Landline Screener - Child

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	58,772	68,846	0	-10,074	0	0
Annual Time Burden (Hours)	6,073	6,615	0	-542	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Total estimated ACBS burden will decrease due to a reduction in the BRFSS sample which provides the starting point for ACBS sampling and respondents. The proportion of respondents recruited from the landline phone sample will decrease and the proportion of respondents recruited from the cellphone sample will increase. There will be changes to the content of both the adult questionnaire and the child questionnaire. The burden of additional questions will be offset by the deletion of selected questions, therefore the estimated burden per response for each questionnaire will not change., however, the burden per response for the child screener will increase from 1 minute to 2 minutes.

---

Annual Cost to Federal Government: $2,200,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/07/2023

---